| Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
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| Chapter Links... |
 NICE TA 539: Neuroendocrine tumours (metastatic, unresectable, progressive) - 177 Lu-dotatate |
| Details... |
| 08.02.04 |
Other immunomodulating drugs |
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BCG Connaught
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Formulary
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Vial: 81mg for bladder instillation
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Brodalumab (Kyntheum ® )
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Formulary
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210mg solution for infusion
Brodalumab for treating moderate to severe plaque psoriasis (TA511) 21.3.18
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Cemiplimab (Libtayo®)
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Formulary
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Cemiplimab (Libtayo®) is recommended for use within the Cancer Drugs Fund as an option for treating locally advanced or metastatic cutaneous squamous cell carcinoma in adults when curative surgery or curative radiotherapy is not appropriate.
It is recommended only if the conditions in the managed access agreement are followed.
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NICE TA 592: Cemiplimab for treating metastatic or locally advanced cutaneous squamous cell carcinoma
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Dimethyl fumarate
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Formulary
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Capsules: 120mg, 240mg
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NICE TA 303: Teriflunomide for treating relapsing–remitting multiple sclerosis
NICE TA320: Dimethyl fumarate for treating relapsing‑remitting multiple sclerosis
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Dinutuximab beta (Qarziba®)
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Formulary
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20mg/4.5mL concentrate for solution for infusion
Approved for the treatment of high-risk neuroblastoma in people aged 12 months and over in line with NICE
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NICE TA 538: Dinutuximab beta for treating neuroblastoma
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Durvalumab (Imfinzi®)
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Formulary
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Durvalumab (Imfinzi®) monotherapy is recommended for use within the Cancer Drugs Fund as an option for treating locally advanced unresectable non-small cell lung cancer in adults whose tumours express PD‑L1 on at least 1% of tumour cells and whose disease has not progressed after platinum-based chemoradiation only if:
- they have had concurrent platinum-based chemoradiation, and
- the conditions in the managed access agreement are followed.
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NICE TA 578: Durvalumab for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation
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Fingolimod
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Formulary
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Capsules: 500microgram - - approved for the treatment of highly active relapsing–remitting multiple sclerosis in line with NICE - approved for patients who have progressed on glatiramer acetate and for those patients who are at high risk of progressive multifocal leukoencephalopathy (PML) in line withNHS EnglandClinical Commissioning Policy
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NICE TA 254: Fingolimod for the treatment of highly active relapsing–remitting multiple sclerosis
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Lenalidomide
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Formulary
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Capsules: 5mg, 10mg, 15mg, & 25mg
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NICE TA 586: Lenalidomide plus dexamethasone for multiple myeloma after 1 treatment with bortezomib
NICE TA 587: Lenalidomide plus dexamethasone for previously untreated multiple myeloma
NICE TA171: Multiple myeloma - lenalidomide
NICE TA322: Lenalidomide for treating myelodysplastic syndromes associated with an isolated deletion 5q cytogenetic abnormality
NICE TA627: Lenalidomide with rituximab for previously treated follicular lymphoma
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Mifamurtide
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Formulary
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Vial: 4mg
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NICE TA 235: Mifamurtide for the treatment of osteosarcoma
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Nivolumab
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Formulary
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Concentrate for IV infusion: 10mg in 1ml concentrate for IV infusion as (4ml, 10ml & 24ml vials)
For the treatment of locally advanced or metastatic squamous nonsmall cell lung cancer (NSCLC) after prior chemotherapy in adults
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NICE TA 417: Nivolumab for previously treated advanced renal cell carcinoma
NICE TA 462: Nivolumab for treating relapsed or refractory classical Hodgkin lymphoma
NICE TA 581: Nivolumab with ipilimumab for untreated advanced renal cell carcinoma
NICE TA384: Nivolumab for treating advanced (unresectable or metastatic) melanoma
NICE TA 400: Nivolumab in combination with ipilimumab for treating advanced melanoma
NICE TA 558: Nivolumab for adjuvant treatment of completely resected melanoma with lymph node involvement or metastatic disease
NICE TA 655: Nivolumab for advanced squamous non-small-cell lung cancer after chemotherapy
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Pomalidomide (Imnovid®)
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Formulary
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Capsules: 1mg, 2mg, 3mg, 4mg
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NICE TA 427: Pomalidomide for multiple myeloma previously treated with lenalidomide and bortezomib
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Siponimod (Mayzent®)
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Formulary
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Tablet: 250 micrograns and 2 mg
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NICE TA 656: Siponimod for treating secondary progressive multiple sclerosis
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Teriflunomide
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Formulary
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Film coated tablets: 14mg
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NICE TA303: Teriflunomide for relapsing remitting MS
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Thalidomide
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Formulary
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Capsules: 50mg
- approved in combination with an alkylating agent and a corticosteroid for the first-line treatment of multiple myeloma in line with NICE
- approved for the treatment of bleeding from bowel angiodysplasia in patients with an inherited/acquired bleeding disorder on specialist advice only.
-approved for the treatment of severe epistaxis as a result of hereditary haemorrhagic telangiectasia (HHT) who have failed all other treatments.
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NICE TA 228: Bortezomib and thalidomide for the first‑line treatment of multiple myeloma
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| 08.02.04 |
Interferon Alfa |
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Interferon alfa-2b
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Formulary
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Multidose pen injections: 10 mega units, 30 mega units
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Peginterferon alfa-2a
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Formulary
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Injections in prefilled syringes 135 microgram, 180 microgram
Prefilled pens: 135 micrograms and 180 micrograms
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NICE TA 106: Peginterferon alfa and ribavirin for the treatment of mild chronic hepatitis C
NICE TA 200: Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C
NICE TA 300: Peginterferon alfa and ribavirin for treating chronic hepatitis C in children and young people
NICE TA 75: Interferon alfa (pegylated and non-pegylated) and ribavirin for the treatment of chronic hepatitis C
NICE TA 96: Adefovir dipivoxil and peginterferon alfa-2a for the treatment of chronic hepatitis B
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Peginterferon alfa-2b
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Formulary
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Prefilled injection pens: 50, 80, 100, 120, 150 micrograms
-approved for chronic hepatitis C as peginterferon alffa 2a
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| 08.02.04 |
Interferon beta |
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Interferon beta-1a
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Formulary
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Prefilled pen (Avonex): 30 micrograms (6 million units)
Prefilled pen (Rebif): 22 microgram (6 million units) & 44 microgram (12 million units)
Cartridge for use in rebismart device: 22 microgram per 0.5ml and 44 microgram per 0.5ml
Prefilled pen: 44 microgram per 0.5ml (Rebidose)
-approved for use when the cartridges and prefilled syringes are unsuitable.
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Interferon beta-1b
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Formulary
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Vials for preparing 750 microgram in 3ml injection (Betaferon)
Vials for preparing 250 microgram in 1ml injection (Extavia)
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Peginterferon beta-1a
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Formulary
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Prefilled pen: 125 microgram (Plegridy)
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NICE TA624:Peginterferon beta-1a for treating relapsing–remitting multiple sclerosis
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| 08.02.04 |
Aldesleukin |
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| 08.02.04 |
Glatiramer acetate |
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Glatiramer Acetate
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Formulary
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Prefilled syringe injection: 20mg
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NICE TA 527: Beta interferons and glatiramer acetate for treating multiple sclerosis
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| 08.02.04 |
Natalizumab |
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Natalizumab
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Formulary
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Vial for preparing infusions: 300mg in 15ml (20mg/ml)
- approved for rapidly evolving severe relapsing remitting multiple sclerosis in line with NICE
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NICE TA127: Multiple sclerosis - natalizumab
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| Non Formulary Items |
Aldesleukin (Proleukin®)
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Non Formulary
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Canakinumab (Ilaris®)
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Non Formulary
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Cediranib (Recentin®)
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Non Formulary
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Cobimetinib (Cotellic®)
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Non Formulary
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Fampridine
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Non Formulary
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Pemrolizumab (Keytruda®)
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Non Formulary
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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Cancer Drugs Fund
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
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Description |
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Drugs for hospital use or use by a specialist within specialist centre only. Initiation and monitoring of treatment should remain under the total responsibility of the appropriate hospital clinician or specialist.
These drugs should only be prescribed under the direct supervision of that clinician or specialist and are not suitable for shared care arrangements. The drug should be supplied via the hospital or specialist centre for the duration of treatment.
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These are specialist drugs which must be initiated by secondary care specialist prescribers, but with the potential to transfer prescribing to primary care within written and agreed shared care protocols and according to the agreed process for transfer of care.
For these drugs, in order to ensure patient safety, some aspects of care must remain with the specialist due to their complexity e.g. monitoring of disease or drug response. Other more routine aspects can be transferred to the GP e.g. monitoring of adverse effects and supply of the medicine. The specific responsibilities of the specialist and GP are defined in the shared care agreement for each drug.
Shared care agreements are still under development for some amber drugs. Until these are available, it would be expected that any shared care request from secondary care to a GP would be accompanied by written information which defines prescribing and monitoring responsibilities. The hospital specialist should also provide the GP with enough information and support to allow the safe transfer and ongoing management of prescribing into primary care.
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Drugs which should usually be initiated in secondary care, or by a specialist clinician, but can be safely maintained in primary care with very little or no monitoring required. In some cases there may be a further restriction for use outlined - these will be defined in each case. |
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These are defined as new and established drugs, which may be prescribed, initiated, changed or maintained on FP10 by the GP and, if appropriate, discontinued without recourse to secondary care.
N.B. DRUGS NOT IDENTIFIED IN THE FORMULARY BY A RED, AMBER OR GREEN+ SYMBOL ARE CLASSIFIED AS GREEN. |
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